Hamna imdad, Humaira Anjum


Introduction: Timely diagnosis of meniscal pathology is vital for determining type and timing of treatment, as well as prognosis for return to function. Ultrasonographic examination of the knee shows promise for being an effective diagnostic tool for assessing meniscal pathology with the potential to overcome many of the shortcomings of MRI.

Objective: To determine the diagnostic accuracy of high frequency ultrasound in the diagnosis of Meniscal Injuries keeping arthroscopy as a gold standard.

Study Settings: Radiology Department, Khyber Teaching Hospital Peshawar.

Study Duration: From 03-05-2018 to 03-11-2018

Materials and Methods: This study was conducted in the Department of Radiology, Khyber Teaching Hospital, Peshawar. Through a Descriptive Cross Sectional Study Design, a total of 125 cases suspected of having meniscal injury were included in the study in a consecutive manner and subjected to high frequency ultrasound followed by arthroscopy for the confirmation of meniscal injuries.

Results: The mean age of the patients was 36.7 + 9.2 years. We had 71.2% males & 28.8% females. The mean BMI of the study sample was 23 + 2.1 kg/m2. On HFUS we observed meniscal injury in 73.6% of patients compared to 60% on follow up arthroscopy. On applying the formulae for calculation, sensitivity of meniscal injury was found to be 81.3% and specificity 38%. The positive predictive value of the HFUS was 66.3% and negative predictive value was 57.6%.

Conclusion: High frequency ultrasound has an acceptable sensitivity and specificity for the detection of meniscal injuries. As such, it is a useful radiological marker for diagnosis of meniscal injuries in adults and further studies are recommended to confirm its usefulness.

Key Words: High frequency ultrasound (HFUS), arthroscopy, knee, menisci, meniscal injuries.

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Stensrud S, Roos EM, Risberg MA. A 12-week exercise therapy program in middle-aged patients with degenerative meniscus tears: a case series with 1-year follow-up. J Orthop Sports Phys Ther. 2012;42:919–31.

Neogi DS, Kumar A, Rijal L, Yadav CS, Jaiman A, Nag HL. Role of nonoperative treatment in managing degenerative tears of the medial meniscus posterior root. J Orthop Traumatol. 2013;14:193–99.

Laible C, Stein DA, Kiridly DN. Meniscal repair. J Am Acad Orthop Surg. 2013;21:204–13.

Bhatia S, LaPrade CM, Ellman MB, LaPrade RF. Meniscal root tears: significance, diagnosis, and treatment. Am J Spots Med 2014;42(12):3016-30.

LaPrade RF, Ho CP, James E, Crespo B, LaPrade CM, Matheny LM. Diagnostic accuracy of 3.0 T magnetic resonance imaging for the detection of meniscus posterior root pathology. Knee Surg Sports Traumatol Arthroscop. 2015;23(1):152-7.

Nogueira-Barbosa MH, Gregio-Junior E, Lorenzato MM, Guermazi A, Roemer FW, Chagas-Neto FA et al. Ultrasound assessment of medial meniscal extrusion: a validation study using MRI as reference standard. Am J Roentgenol. 2015;204(3):584-8.

PK SA, Mohan R, Gopakumar TS, Beenamol S. Diagnostic test evaluation of ultra sound and mri compared to arthroscopy in clinically positive meniscal and ligamentous injuries of knee. KJO. 2016;28(1-2):37-41.

Akatsu Y, Yamaguchi S, Sasho T, Takahashi K, Akagi R, Muramatsu Y. Accuracy of high resolution ultrasonography in detecting meniscal tears. J Endo 2013;21:S63-312.

Rohren EM ,Kosare FJ,helms CA.Discoid lateral meniscus and frequency of meniscal tears.skeletal radiol. 2001 jun;30(6);316-20.

Shetty AA, Tindall AJ, James KD, Relwani J, Fernando KW. Accuracy of hand-held ultrasound scanning in detecting meniscal tears. J Bone Joint Surg Br. 2008 Aug;90(8):1045-8.

Jacobson JA. Musculoskeletal ultrasound: focused impact on MRI. AJR Am J Roentgenol. 2009 Sep;193(3):619-27.

Woodhouse JB, McNally EG. Ultrasound of skeletal muscle injury: an update. Semin Ultrasound CT MR. 2011 Apr;32(2):91-100.

Nazarian LN. The top 10 reasons musculoskeletal sonography is an important complementary or alternative technique to MRI. AJR Am J Roentgenol. 2008 Jun;190(6):1621-6.

Khan Z, Faruqui Z, Ogyunbiyi O, Rosset G, Iqbal J. Ultrasound assessment of internal derangement of the knee. Acta Orthop Belg. 2006 Jan;72(1):72-6.

Helwig P, Hauschild O, Bahrs C, Weise K, Schewe B. 3-dimensional ultrasound imaging for meniscal lesions. Knee. 2007 Dec;14(6):478-83.

Petersen LJ, Rasmussen OS. [Ultrasonography as a diagnostic method in suspected meniscal lesion of the knee. A prospective single blind study of 52 patients]. Ugeskr Laeger. 1999 Oct 11;161(41):5679-82.

Smagin NV, Krutyansky LM, Zelenov ZV, Brysev AP. [Measuring the acoustic absorption coefficient in biological tissue specimens using ultrasonic phase conjugation]. Akusticheskij Zhurnal. 2014;60(2):199-203.

Casser HR, Sohn C, Kiekenbeck A. Current evaluation of sonography of the meniscus. Results of a comparative study of sonographic and arthroscopic findings. Arch Orthop Trauma Surg. 1990;109(3):150-4.

De Smet AA, Graf BK. Meniscal tears missed on MR imaging: relationship to meniscal tear patterns and anterior cruciate ligament tears. AJR Am J Roentgenol. 1994 Apr;162(4):905-11.

Terzidis IP, Christodoulou A, Ploumis A, Givissis P, Natsis K, Koimtzis M. Meniscal tear characteristics in young athletes with a stable knee: arthroscopic evaluation. Am J Sports Med. 2006 Jul;34(7):1170-5.

Selby B, Richardson ML, Nelson BD, Graney DO, Mack LA. Sonography in the detection of meniscal injuries of the knee: evaluation in cadavers. AJR Am J Roentgenol. 1987 Sep;149(3):549-53.

Yaniv M, Blumberg N. The discoid meniscus. J Child Orthop. 2007 Jul;1(2):89-96.

Achour NA, Tlili K, Souei MM, Gamaoun W, Jemni H, Dali KM, Dahmen J, Hmida RB. [Discoid menisci in children: ultrasonographic features]. J Radiol. 2006 Jan;87(1):35-40.

Wareluk P, Szopinski KT. Value of modern sonography in the assessment of meniscal lesions. Eur J Radiol. 2012 Sep;81(9):2366-9.

Sampson MJ, Jackson MP, Moran CJ, Shine S, Moran R, Eustace SJ. Three Tesla MRI for the diagnosis of meniscal and anterior cruciate ligament pathology: a comparison to arthroscopic findings. Clin Radiol. 2008 Oct;63(10):1106-11.

Jung JY, Jee WH, Park MY, Lee SY, Kim JM. Meniscal tear configurations: categorization with 3D isotropic turbo spin-echo MRI compared with conventional MRI at 3 T. AJR Am J Roentgenol. 2012 Feb;198(2):W173-80

Acebes C, Romero FI, Contreras MA, Mahillo I, Herrero-Beaumont G. Dynamic ultrasound assessment of medial meniscal subluxation in knee osteoarthritis. Rheumatology (Oxford). 2013 Aug;52(8):1443-7.

Bangard C, Paszek J, Berg F, Eyl G, Kessler J, Lackner K, Gossmann A. MR imaging of claustrophobic patients in an open 1.0T scanner: motion artifacts and patient acceptability compared with closed bore magnets. Eur J Radiol. 2007 Oct;64 (1):152-7

Friedman L, Finlay K, Popovich T, Chhem RK. Sonographic findings in patients with anterior knee pain. J Clin Ultrasound. 2003 Feb;31(2):85-97.

Friedman L, Finlay K, Jurriaans E. Ultrasound of the knee. Skeletal Radiol. 2001;30-7:361-77.

Wareluk P, Szopinski KT. Value of modern sonography in the assessment of meniscal lesions. Eur J Radiol. 2012 Sep;81(9):2366-9.


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